Answer to Question 1
ANS: C
Because levodopa activates the chemoreceptive trigger zone (CTZ) of the medulla, causing nausea and vomiting (N/V), the patient may need to take a lower dose temporarily until tolerance develops. A meal helps slow absorption to minimize this side effect. A high protein intake contributes to abrupt loss of effect, so meals should be low in protein. Taking a dose on an empty stomach increases absorption and also N/V. An increased dose with a high-protein snack increases N/V and also abrupt loss of effect. Dopamine increases N/V, because it activates the CTZ of the medulla.
Answer to Question 2
ANS: D
Patients beginning therapy with levodopa/carbidopa should expect therapeutic effects to occur after several months of treatment. Levodopa is so effective that a diagnosis of PD should be questioned if the patient fails to respond in this time frame. Adding a dopamine agonist is not indicated. The on-off phenomenon occurs when therapeutic effects are present. Increasing the dose of levodopa/carbidopa is not indicated.
Measuring Patient Height
Patient teaching: male genetalia assessment
ROM exercises on a patient’s wrist: radial deviation.
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A histologic slide showing the sponge-like architecture of a patient with Creutzfeldt-Jakob Disease.
Medical Gymnasts Assist Patient in Performing Movements, 1909.